Vietnam Reports 4 New Bird Flu Cases

Action Points

Be prepared to answer patients' questions about the growing number of bird flu patients in Asia. Advise patients that avian flu is a different disease than the standard flu.

Advise patients about the importance of getting inoculated against standard influenza, especially children, the elderly, and patients with compromised immune systems.

GENEVA, March 9-The World Health Organization has reported four new cases of human avian influenza, including the death of a 21-year-old man.

All four became ill in early or mid-February. The 21-year-old man's 14-year-old sister was also sick with the colloquially known bird flu, but her condition was unknown. The status of the other two patients was also not known.

These four new cases come after a 26-year-old nurse was admitted to a hospital in Hanoi last week and tested positive for influenza A (H5N1). Health officials are currently determining whether he is yet another avian influenza patient. His case is of particular interest to health officials because he carried a bird flu patient on a stretcher and provided direct care at a hospital. Most human bird flu is believed to have been caused by contact with contaminated poultry. Vietnamese officials are trying to determine whether the nurse also came into contact with sick poultry.

The rise in the number of cases comes amid the looming possibility that the avian strain's genes may mix with DNA from human influenza viruses, a potential nightmare scenario for WHO. "It is difficult to say how severe a threat this would be, because we are unable to predict what kind of pathogenicity this new pandemic strain would have," Maria Cheng, a spokeswoman for WHO, told MedPageToday. "It is certainly a dilemma for WHO that a pandemic risk has been identified yetwe have no way of accurately predicting when that pandemic might occur. WHO is currently encouraging countries to adopt pandemic preparedness plans so that when the pandemic does arrive, the necessary steps can be implemented to ensure a rapid response and the production of a vaccine."

WHO said health authorities need more information on new bird flu cases because data gleaned from them could reveal to scientists whether the molecular composition of the virus is evolving and how they can best target therapies to protect against it.

Vietnam has now reported 42 cases to WHO, including the most recent four. Of those, at least 31 have died. Thailand has reported 17 cases of bird flu, 12 of whom have died. Cambodia has reported one fatal case. Those numbers could increase; infectious disease and laboratory workers from WHO, the United States and Japan are working with Vietnamese officials to improve the accuracy of their flu testing. Tokyo scientists are testing seven people for the avian A (H5N1) in Vietnam who had originally been classified as negative.

Reviewed by Zalman S. Agus, MD Emeritus Professor at the University of Pennsylvania School of Medicine